Tumours of the posterior skull base

This article outlines general aspects, diagnosis and the surgical management of posterior skull base tumours, including preoperative studies and nonsurgical modalities of treatment. The vast majority of tumours of the posterior skull base are of histologically benign nature but biologically malignant behaviour. In detail, tumours of the posterior skull base may be classified into tumours of the clivus or the petroclival region, the cerebellopontine angle and the foramen magnum. The management of these tumours has been revolutionized in recent years. Microsurgical resection is considered the mainstay of therapy because for most of these tumours chemotherapy or conventional radiotherapy has not been proven to be an effective treatment. The application of cranial base approaches combined with the techniques of neuromonitoring and the refinements of microsurgical techniques have greatly reduced postoperative morbidity and mortality in these patients.